DISTRICT COURT OF ______________COUNTY, KANSAS Small Claims Procedure ______________________________________________________________ Plaintiff-name and address vs. ______________________________________________________________ Defendant-name and address Case No. _________________ PETITION Pursuant to Chap. 61 of K.S.A. To Plaintiff: Read instructions on page two of this form. Set forth a short and plain statement of claim below. Plaintiff, having read the instructions on page two of the petition, asserts the following claim against the above named defendant (s). __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Based on the claim stated above, judgment is demanded against defendant (s) as follows: (check applicable provision) ______Payment of $__________, plus interest, costs and any damages awarded under K.S.A. 60-2610. ______Recovery of the following described personal property, plus costs-estimated value of property $____________. (Not to exceed $4,000.00) The plaintiff, hereby swears that, to the best of his/her knowledge and belief, the above claim asserted against the defendant (s) ( including the estimate of value of a property sought to be recovered) is just and true statement, exclusive of any valid claim or defense which defendant(s) may have. Please indicate here if Plaintiff is an attorney or corporation, etc. _____ yes _____no Executed On _________________________. __________________________________________ Signature of Plaintiff The trial on this matter is set for _______________________________, at ____________ ___.m. at _________________________________________________________________________________________ Place of hearing and address American LegalNet, Inc. www.USCourtForms.com Instructions to Plaintiff r State the claim you have against the defendant (s) in the space provided on the petition form. Be clear and concise. r Your total claim against defendant may not exceed $4,000.00, not including interest, cost and any damages awarded under K.S.A 60-2610. If you are seeking the recovery of personal property, the value of that property shall be based on your estimate of its value under unsworn declaration under penalty of perjury. r You must be present in person at the hearing in order to avoid default judgment against you on any claim defendant(s) may have which arises out the transaction or occurrence which is the subject of your claim against the defendant(s). r You must make demand for judgment in one or both of the spaces provided on the petition form. r Except provided by law, neither you nor the defendant(s) are permitted to appear with an attorney at the hearing unless the other party is an attorney or was formerly an attorney. In such cases you are entitled to one continuance to obtain an attorney. r You may not file more than ten small claims under the small claims procedure act in this court during any calendar year. r After completing the petition form you must sign it. Your signature is under unsworn declaration under penalty of perjury. American LegalNet, Inc. www.USCourtForms.com